Laparotomy sheet

ABSTRACT

A disposable laparotomy sheet comprises a major sheet of porous nonwoven fabric and a minor sheet of opaque, glare-resistant plastic near the center of the major sheet and including a fenestration to define the operative area.

United States Patent Endres 1 51 Oct. 3, 1972 LAPAROTOMY SHEET [72]Inventor: Dan D. Endres, Memphis, Tenn.

[73] Assignee: Kimberly-Clark Corporation,

Neenah, Wis.

[22] Filed: March 30, 1970 [21] Appl. N0.: 23,570

3,503,391 3/1970 Melges ..l28/l 32 D 3,060,932 10/1962 Pereny et al..128/l32 D FOREIGN PATENTS OR APPLICATIONS 944,329 12/1963 GreatBritain..12s/132D 148,164 12/1954 Sweden ..128/l32D Primary Examiner-LawrenceCharles Attorney-Wolfe, Hubbard, Leydig, Voit & Osann, Ltd. v

[57] ABSTRACT A disposable laparotomy sheet comprises a major sheet ofporous nonwoven fabric and a minor sheet of opaque, glare-resistantplastic near the center of the major sheet and including a fenestrationto define the operative area.

5 Claims, 7 Drawing Figures LAPAROTOMY SHEET This invention relates tosurgical drapes, and more particularly concerns a disposable laparotomysheet featuring outstanding simplicity, versatility, and little cost.

For surgical operations and other hospital procedures it is conventionalto drape all or a portion of the patient with a laparotomy sheet. Thesheet has a generally central fenestration to expose the operative orsurgical area.

Early laparotomy sheets, and indeed many such sheets in use today, weremade of woven textile material. While this was satisfactory, if but inthe sense of widespread use, the cost of such sheets, the cost oflaundering them, and the cost of sterilizing them for reuse has led inrecent years to the growing adoption of disposable laparotomy sheets.Not infrequently, the cost of a sterile disposable sheet is less thanthe cost of laundering and sterilizinga woven fabric sheet.

As materials for the disposable sheet the choice is usually betweennonwoven paper-like fabrics on the one hand, and plastic sheeting on theother. Both have their features and disadvantages.

Nonwoven fabric disposable sheets are attractive, convenient, and nottoo dissimilar to woven fabrics. Opposed to this, they tend to besomewhat more slippery, and usually are thinner than woven textileswhich prevents their being as effective in absorbing perspiration andblood or other body fluids. Plastic laparotomy sheets are almostinvariably even more slippery and, in addition, reflect glare from theintense operating room lights. Further, whether or not justified,-all-plastic sheets have a reputation for producing static electricity.Moreover, by reason of their imperviousness plastic sheets cause thepatient to perspire.

Accordingly, a principal object of the invention is to provide a noveldisposable laparotomy sheet that integrates the benefits of nonwovenfabric sheets and those made of plastic, while at the same time avoidingtheir respective limitations.

An additional object is to provide a disposable laparotomy sheet whichis unusually low in cost, easy to manufacture, and convenient to use.

Other and further objects, aims, and advantages of the invention willbecome apparent as the description of the invention proceeds withreference to the annexed drawings wherein:

FIG. 1 is a top plan view, somewhat schematic, of one embodiment of theinvention;

FIG. 2 is a top plan view of an alternative, preferred, embodiment;

FIG. 3 is an enlarged sectional view, taken along line 3-3 of FIG. 2,with the components grossly exaggerated for reasons of clarity ofpresentation; and

FIGS. 4 through 7 depict sequentially the manner of un-folding a pack(FIG. 4) of a folded laparotomy sheet according to FIG. 2, orconversely, of folding the sheet into a pack.

While the invention will be described in conjunction with certainpreferred embodiments, it will be understood that it is not intended tolimit the invention to these particular embodiments. On the contrary, itis intended to cover all alternatives, modifications, and equivalentarrangements as may be included within the spirit and scope of theinvention.

Turning now to the drawings, and particularly to FIG. 1, one form of theinvention is depicted somewhat schematically. The laparotomy sheet 10 inthis instance comprises three sections, namely a head area 11 and a footarea 12 both made of porous nonwoven fabric material, and a central orminor area 14 composed of a plastic, as will be explained subsequentlyin more detail. Near the center of the sheet 10 is a fenestration 15,shown in dashed lines to indicate that, in the described embodiment, theelongated fenestration 15 is perforated until use, whereupon the portion16 is removed entirely to expose the operative or surgical field. Thehead and foot areas ll, 12 constitute the major nonwoven sheet, and arespaced away from the fenestration 15 by the minor plastic area 14 whichextends completely across the sheet 10.

By way of example, the laparotomy sheet 10 is 44 inches wide by 1 18inches long. The fenestration 15, a generally oblong aperture about 12inches long by 4 inches wide, is positioned with the edge nearest thehead end of the sheet 10 located approximately 44 inches from the end,and the edge or periphery of the fenestration 15 located near the footend of the sheet 10 being 62 inches from the end. Also, the fenestration15 is located centrally of the central area 14, and this, in turn, isapproximately 40 by inches.

Nonwoven fabric materials constituting the head and foot area ll, 12respectively are available commercially, and many examples of thesematerials have been described in the literature. See, for example,Buresh, Nonwoven Fabrics (Reinhold, New York, 1962), and Krema, NonwovenTextiles (SNTL, Prague, 1962). In essence, nonwoven fabrics are thinmattings of natural or synthetic textile fibers bonded together by anyof various bonding media. The thickness of these nonwoven fabrics may bevaried widely, and more than one sheet of nonwoven fabric may belaminated together if additional thickness is required.

The central area 14 is advantageously a strong, thin, plastic material,typified by low density polyethylene, polyvinyl chloride, or the like,which is pigmented sufficiently to become opaque. Polyethylene film ispresently the material of choice, and may be used at a thickness ofabout 1 to about 5 mils.

In accordance with one feature of the invention, glare from operatingroom lights is minimized or eliminated by embossing the upper surface ofthe sheet 14. Embossed polyethylene and other plastic sheets arelikewise available commercially, and are usually prepared by calenderinga sheet between calender rolls of which one roll has a roughened orgrooved surface. The other roll may similarly be grooved, or may be aresilient material such as rubber. See, for example, Billmeyer, Textbookof Polymer Science (Interscience, New York, 1962), at pages 493 and 497.Advantageously, the plastic sheet is embossed with a simulated leathergrain, with the individual grains being approximately one thirty-secondinch. Thus, not only does the embossing diffuse reflected light andthereby minimize glare, but it provides a less slippery finish for theplastic in order to reduce the tendency of the sheet 10 to slip, or ofinstruments to slide off.

To reduce the tendency of plastics to accumulate electrostatic charges,various anti-static agents are available for incorporation into theplastic film. These tend to be proprietary with the film manufacturer,but examples are included, for example, in Raff and Allison,Polyethylene" (Interscience, New York, I956), atpages4l6,4l7.

As shown in FIG. 1, the nonwoven fabric head and a foot areas orportions ll, 12 are spaced away from the fenestration 15 by asubstantial distance, and are secured to the plastic central area neartheir common edges 17, 19. These edges 17, 19 are lap joints, with asuitable adhesive used to secure the sheets at the laps.

It is apparent, therefore, that the combination of plastic in thecentral area 14 and nonwoven fabric in the head and foot areas 11, 12permits the advantages of both materials to be realized. The centralarea 14 is fluid impervious, and therefore prevents leakage of blood orother body fluids to undesired areas of the anatomy, while the porousnonwoven portions provide some degree of ventilation for the patient.

An even more advantageous embodiment of the invention is portrayed inFIG. 2, and in an enlarged section of FIG. 2 shown in FIG. 3. Insubstance, in this embodiment the disposable laparotomy sheet 20comprises a major sheet of porous nonwoven fabric 21, and a generallyrectangular plastic sheet 22 which extends over a central portion of themajor sheet 21 and is secured to the sheet 21 by a suitable adhesive. Inthis case, the fenestration 24 is defined by an elongated aperture inthe plastic central sheet 22, while a larger aperture has its edgesspaced away from the periphery of the fenestration 24. The spacing may,illustratively, be 1 inch on each side and 2 inches at the end, althoughthis may be varied (as, indeed, may the size of the aperture 24) toaccommodate operative fields of expectedly different sizes.

By way of illustration, the embodiment of FIG. 2 has the same overalland fenestration dimensions, as well as fenestration location, as dothat of the FIG. 1 embodiment. The central sheet 22 is inches wide and45 k inches long; the fenestration 24 is located 12 k inches from thehead end of the laparotomy sheet 20 and 21 inches from the foot end.

Although not shown in FIGS. 2 and 3, the major sheet 21 may be composedof two portions. In this event, it is convenient to join them near oneend of the fenestration 24, by an adhesively secured lap joint.

The central sheet 22 is, as previously indicated, adhesively attached tothe major sheet 21 of nonwoven fabric material. An adhesive strip of,say, one-eighth inches wide along the outside edges of the central sheet22, while another adhesive strip of, say, three-eighths inch widthsecures the central area of the central sheet 22 near the region of theaperture 25. If desired, a normally tacky and pressure sensitiveadhesive may be used for at least the adhesive near the aperture 25 andapplied also to the portion of the central sheet 22 between thefenestration 24 and the aperture 25. Thus, a pressure sensitive adhesiveis available on the portion 26 in the event it is desired to secure thelaparotomy sheet 20 to the anatomy of a patient during a surgicalprocedure. Should this option be desired, an abherent peel strip may beplaced over the portion 26 and removed just before placement of thesheet 20 on the patient. Suitable pressure sensitive adhesives, andsuitable abherents, are described, respectively, in Kirk- Ordinarily,and irrespective of whether an adhesive is used on the portion 26 of thelaparotomy sheet 20, the sheet is placed over a patient with the plasticcentral sheet 22 facing upward. This, however, is not necessary whenthere is no adhesive on the portion 26, and consequently the plasticside may be either above or belo the main sheet 21 as the surgeonprefers.

Turning now to FIGS. 4 through 7, these drawings depict the procedure ofunfolding a folded pack of the laparotomy sheet 20 shown in FIG. 2.Proceeding inversely from FIG. 7 to FIG. 4, the drawings indicate themethod of folding the sheet 20, first with the head and foot portionsfolded accordionwise toward the center so as to cover the plasticcentral portion 22 (FIG. 7), then accordionwise from each side (FIGS. 6and 5) to make a compact package (FIG. 5), and finally doubled over(FIG. 4). Unfolding follows the opposite procedure, that is, from FIG. 4through FIG. 7 in sequence.

Thus there has been provided, in accordance with the invention, alaparotomy sheet that fully satisfies the objectives, aims, andadvantages set forth earlier. The sheet of the invention is remarkablysimple, and yet possesses unusual advantages with few if anydisabilities.

I claim as my invention:

1. In a disposable laparotomy sheet of the type having a major sheet ofporous nonwoven fabric, including head and foot areas, and afenestration in said laparotomy sheet to expose the operative area, theimprovement comprising:

an opaque pigmented, embossed, fluid impervious plastic sheet adhesivelysecured to said major sheet and covering the upper surface thereof inthe region of said fenestration to prevent fluid strike through,

said plastic sheet having said fenestration therein;

and

the combination of said plastic sheet being embossed and opaquepigmented being effective to diffuse reflected light and therebyminimize glare, said embossed sheet being effective to provide a lessslippery finish and thereby reduce the tendency of surgical instrumentsto slide off when placed thereon.

2. Sheet of claim 1 wherein said plastic sheet extends completely acrosssaid laparotomy sheet to separate said head and said foot areas, saidhead and said foot areas being respectively adhesively secured toopposite edges of said plastic sheet.

3. Sheet of claim 1 wherein said plastic sheet extends over a generallycentral portion of said laparotomy sheet, the major sheet having anaperture therein larger than said fenestration with the edges of saidaperture being spaced away from the periphery of said fenestration.

4. Sheet of claim 1 wherein said plastic comprises polyethylene.

5. The sheet of claim 1 wherein the exposed upper surface of said majorsheet is spaced from said fenestration.

1. In a disposable laparotomy sheet of the type having a major sheet ofporous nonwoven fabric, including head and foot areas, and afenestration in said laparotomy sheet to expose the operative area, theimprovement comprising: an opaque pigmented, embossed, fluid imperviousplastic sheet adhesively secured to said major sheet and covering theupper surface thereof in the region of said fenestration to preventfluid strike through, said plastic sheet having said fenestrationtherein; and the combination of said plastic sheet being embossed andopaque pigmented being effective to diffuse reflected light and therebyminimize glare, said embossed sheet being effective to provide a lessslippery finish and thereby reduce the tendency of surgical instrumentsto slide off when placed thereon.
 2. Sheet of claim 1 wherein saidplastic sheet extends completely across said laparotomy sheet toseparate said head and said foot areas, said head and said foot areasbeing respectively adhesively secured to opposite edges of said plasticsheet.
 3. Sheet of claim 1 wherein said plastic sheet extends over agenerally central portion of said laparotomy sheet, the major sheethaving an aperture therein larger than said fenestration with the edgesof said aperture being spaced away from the periphery of saidfenestration.
 4. Sheet of claim 1 wherein said plastic comprisespolyethylene.
 5. The sheet of claim 1 wherein the exposed upper surfaceof said major sheet is spaced from said fenestration.